ContextAdolescence is a period of transition that involves biological, cognitive, psychological and social changes. During the vulnerable transition period of adolescence, decisions relating to contraception may occur. The purpose of this study was to examine the relationship between female adolescent self-esteem, decision making and contraceptive behavior. Understanding the relationship between female adolescent self-esteem, decision-making and contraceptive behavior has contributed to the knowledge base about female contraceptive behavior. Gaining further insight into these relationships will help health care professionals provide counseling and health care to female adolescents.

MethodsUsing a descriptive cross sectional survey design, data were collected from a convenience sample of 98 female adolescents aged 14-17 who came to 5 different clinics in Hawaii for health care. Along with a brief demographic questionnaire, global self­ esteem was measured by Rosenberg's SelfEsteem Scale (Rosenberg, 1965), decision­ making was measured by the Flinders Adolescent Decision Making Questionnaire (Mann, Harmoni, Power, Beswick & Ormond, 1988) and sexual activity and contraception use was measured by a Sexual History and Contraceptive Use Questionnaire developed for this study. The conceptual framework for this study was Janis and Mann's (1977) conflict theory of decision-making. Descriptive statistics, logistic regression and correlations were used to analyze associations and correlations between age, global self esteem, decision self esteem, decision coping (vigilant and maladaptive) and contraceptive use for sexually active female adolescents.

ResultsNo significant associations or correlations were found between age, global self-esteem, decision self esteem, decision coping (vigilance) and their decision to use contraception in sexually active adolescent females. There was, however, significant negative correlation (pincrease on the maladaptive scale, the odds of using contraception were estimated to decrease by 7% meaning those who scored higher on the maladaptive scale were less competent or poor decision makers and less likely to use contraception.

ConclusionsAdolescents who score higher on the maladaptive decision-making scale are less competent in decision-making and are less likely to use contraception. Interventions focused on improving decision-making skills and stimulating thinking around not only sexual issues, but also relationship and communication in adolescent issues, may facilitate more competent decision-making.

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